Purpose To estimate susceptibility to smoking among never-smoking youth globally and identify factors associated with such behavior. Methods Cross-sectional data for 168 countries were obtained from the Global Youth Tobacco Survey. Simple and multiple logistic regression analyses were conducted. Frequencies and proportions for descriptive statistics, and adjusted odds ratios with 95% confidence intervals for logistic regression models were reported. Results Approximately 12.5% of never-smoking youth worldwide were susceptible to smoking worldwide, of which 7.2% were males and 5.3% were females. Compared with youth in the Americas, those in other WHO regions were associated with decreased susceptibility to smoking. Regardless of gender, exposure to parental or peer smoking, secondhand smoke inside or outside home, and tobacco industry promotion was associated with increased smoking susceptibility. In contrast, support for smoke-free policies and school antismoking education was associated with decreased susceptibility to smoking among females. Moreover, exposure to antismoking media messages was associated with increased susceptibility to smoking among never-smoking youth. Conclusions Approximately 1 in 8 never-smoking youth worldwide was found to be susceptible to smoking. A comprehensive approach involving parental and peer education, smoke-free policies, ban on tobacco advertising and promotions, and antismoking education in schools should be developed by policy makers and public health professionals to protect never-smoking youth from being susceptible to smoking and transforming into future regular smokers.

Matrix variate skew elliptically contoured distributions generalize several classes of important distributions. This paper defines and explores matrix variate skew elliptically contoured distributions. In particular, we discuss the first two moments of the matrix variate skew elliptically contoured distributions.

This study looked at risk factors associated with vitamin D levels in the body among a representative sample of adults in the U.S., NHANES III (2001-2006) data were used to assess the relationship between several demographic and health risk factors and vitamin D levels in the body. The Baseline-Category Logit Model was used to test the association between vitamin D level and the potential risk factors age, education, ethnicity, poverty status, physical activity, smoking, alcohol, obesity, diabetes and total cholesterol with both genders. Vitamin D insufficiency and deficiency were significantly associated with age, race, education, physical activity, obesity, diabetes and total cholesterol level for both genders. Almost half of the adults sampled in these data had vitamin D levels lower than the recommended limits, with the highest frequency among the younger groups. Determining an individual’s vitamin D level is very difficult without proper clinical testing. Many of those who have low vitamin D levels are unaware. With such a high prevalence of individuals with low vitamin D levels in the U.S. and a better understanding of characteristics associated with these lower levels, increased education and prevention efforts should be focused toward those with higher risk characteristics.

Background: Chronic obstructive pulmonary disease (COPD) has been a major public health problem due to its high prevalence, morbidity, and mortality. Smoking is a major risk factor for COPD, while serious psychological distress (SPD) is prevalent among COPD patients. However, no study focusing on the effect of SPD on COPD has been so far conducted, while few studies have focused on the associations of SPD and behavioral factors with COPD by smoking status. Objectives: This study aimed to examine the associations of SPD and behavioral factors (such as smoking and physical activity) with COPD. Materials and Methods: Weighted logistic regression models were used for the analysis of 1,248 cases and 39,995 controls from the 2005 California Health Interview Survey (CHIS). Results: The prevalence of SPD was 10% in cases and 4% in controls, respectively. The percentages of past and current smoking were higher in cases than controls (50% vs. 24% and 27% vs. 15%, respectively). After adjusting for other factors, smoking (OR = 4.56, 95% CI = 3.41-6.11 and OR = 3.24, 95% CI = 2.57-4.08 for current and past smoking, respectively), physical activity (OR = 0.69, 95% CI = 0.55-0.87), obesity (OR = 1.25, 95% CI = 1.03-1.52), older age (OR = 2.86, 95% CI = 2.15-3.82, and OR = 5.97, 95% CI = 4.42-8.08 for middle-aged and elder groups, respectively), SPD (OR = 2.11, 95% CI = 1.47-3.04), employment (OR = 0.62, 95% CI = 0.51-0.76), race (OR = 0.35, 95% CI = 0.23-0.54, OR = 0.59, 95% CI = 0.36-0.97, and OR = 0.47, 95% CI=0.29-0.75 for Latino, Asian, and African American, respectively) and lower federal poverty level (OR=1.89, 95% CI = 1.35-2.63, OR = 1.65, 95% CI = 1.27-2.14, and OR = 1.39, 95% CI = 1.12-1.72 for 0-99% FPL, 100-199% FPL and 200-299% FPL, respectively) were all associated with COPD (P < 0.05). Age group, SPD, race, and employment showed significant interactions with smoking status. Stratified by smoking status, aging was the only risk factor for COPD in the never smoking group; whereas, lack of physical activity, older age, SPD, race, unemployment, and lower federal poverty level were associated with COPD in the smoking groups. Conclusions: Smoking and aging were major risk factors for COPD, while lack of physical activity and SPD were strongly associated with COPD in the smoking groups.

No description available.

Objectives. We quantified controlled substance donations via permanent drug donation boxes over 2 years in a region with high prescription abuse, assessing medication characteristics, time between dispensing and donation, and weight of medications donated per capita. Methods. In partnership with Drug Enforcement Administration and local law enforcement, we analyzed permanent drug donation box collections in 8 Northeast Tennessee locations from June 2012 to April 2014. We recorded controlled substance dosage units along with the product dispensing date. Results. We collected 4841 pounds of pharmaceutical waste, 4.9% (238.5 pounds) of which were controlled substances, totaling 106 464 controlled substance doses. Analysis of dispensing dates for controlled substances indicated a median of 34 months lapsed from dispensing to donation (range = 1–484 months). The mean controlled substance donation rate was 1.39 pounds per 1000 residents. Communities with fewer than 10 000 residents had a statistically higher controlled substance donation rate (P = .002) compared with communities with 10 000 or more residents. Conclusions. Permanent drug donation boxes can be an effective mechanism to remove controlled substances from community settings. Rural and urban community residents should be provided convenient and timely access to drug disposal options.

Purpose: Nonmedical use of stimulant medications (NMUS) among college students is an important and growing problem. The annual prevalence of NMUS among four-year college students has nearly doubled since 2008 and exceeds NMUS in non-college peers. Community college students are an understudied population regarding NMUS. Given noted NMUS differences in 4-year students and non-college peers, one cannot assume community college students’ cognitions, perceptions, and behaviors mirror either peer cohort. We conducted a web-based survey across 10 community colleges in Tennessee (TN) to assess correlates and consequences of NMUS. Methods: We developed an initial version of the 60-item survey questionnaire using previously validated, theoretically based survey items and other items developed by the research team. The survey instrument was then reviewed and assessed for content validity by our research team, and thereafter pilot tested with East Tennessee State University undergraduate students for range measures, item order, and best practices for survey construction. The final 55-item survey instrument was designed using web-based survey software (i.e., Qualtrics). Ten of 13 community colleges in TN granted approval for their students to participate in the study (N=53096). A modified Tailored Design Method approach was utilized to maximize response rate across four email contacts, and monetary incentives were offered to encourage participation in the study. Regulatory authorities (e.g., institutional review boards, institutional offices) from East Tennessee State University and participating community colleges approved the conduct of this study. Data were analyzed using SPSS (version 22). Descriptive statistics were calculated to evaluate prevalence, source, motives and consequences of NMUS. Student’s t-tests and chi-square tests were conducted to compare nonmedical stimulant users and nonusers across a number of variables. Results were considered significant for p < 0.05. Results: A total of 3113 students completed the survey (response-rate = 5.8%), of which 302 (9.7%) were past-year nonmedical stimulant users. A significantly greater proportion of users were diagnosed with a mental health condition (22.2%) than non-users (9.6%). Compared to non-users, significantly greater proportions of users reported using tobacco products, such as cigarettes (34.5% vs. 14%), e-cigarettes (12.5% vs. 4%), and vapors (18.4% vs. 6.7%). Users further reported using more types of illicit drugs (1.9 ± 0.1), more alcoholic drinks per week (2.9±0.3), and more occasions of binge drinking per month (1.8±0.2) than non-users (1.1±0.02, 1.3±0.07, 0.7±0.04, respectively). Only 14.2% of users (n=43 from 302) reported having prescriptions for prescription stimulants. Common sources of prescription stimulants were friends (62.9%), family members (12.3%), and street suppliers (9.9%). Commonly endorsed reasons for NMUS were ‘to improve academic performance’ (63.9%), ‘to have more energy’ (49.7 %), ‘to relieve tension’ (22.2%), and ‘to feel good or get high’ (16.6 %). Adverse effects resulting from NMUS included: lack of appetite (45.4%), difficulty sleeping (38.4 %), and racing heart (31.1%). Unlike the published findings from 4-year college students, low GPA, male gender, Caucasian race and membership in fraternity organizations were not associated with NMUS in community colleges. Conclusion: The present study provides useful information on characteristics of users and patterns and consequences of NMUS in community colleges students. NMUS appears to be associated with illicit substance use, binge drinking and disrupted mental health in community college students in TN. Friends are the most common source and desire to enhance academic performance is the most salient motive for NMUS. Despite facing adverse consequences, college students continued using stimulants nonmedically. These findings underscore the need for development of public health programs that target prevention of NMUS in community colleges.

Community pharmacists in the United States have significant opportunity to engage in community-level prescription substance abuse prevention and treatment efforts, including dissemination of information specific to available addiction treatment options. Our cross-sectional study of Tennessee community pharmacists noted that 26% had previously provided addiction treatment facility information to one or more patients in the past. The purpose of this study was to employ multivariate modeling techniques to investigate associations between community pharmacist and community pharmacy factors and past provision of addiction treatment information to pharmacy patients. Multivariate logistic regression indicated having addiction treatment facility information in a pharmacy setting (aOR=8.19; 95% CI=4.36–15.37), having high confidence in ability to discuss treatment facility options (aOR=4.16; 95% CI=2.65–6.52), having participated in prescription opioid abuse-specific continuing education (aOR=2.90; 95% CI=1.70–4.97), being male (aOR=2.23; 95% CI=1.38–3.59), and increased hours per week in the practice setting (aOR=1.02; 95% CI=1.004–1.05) were all significantly associated with provision of information about addiction treatment. Dissemination of addiction treatment information, improvements in communicative self-efficacy beliefs, and dissemination of prescription opioid abuse-specific continuing education are modifiable factors significantly associated with increased provision of addiction treatment information by community pharmacists.

Abstract available through the Journal of Pharmacy Practice.

Abstract available through Drug and Alcohol Dependence.